Shopping for Drugs: 2004
Table of Contents
- Executive Summary
- Introduction
- Comparing Prices
- Therapeutic Drug Substitution
- Bulk Buying
- Pill Splitting
- Generic Drug Substitutes
- Switching to Over-the-Counter Drugs
- Weighing the Cost and Benefits of a Drug
- Case Studies: Price Comparisons for Specific Drugs
- Buying Drugs Abroad
- Special Opportunities for Seniors: Medicare Discount Drug Cards
- Financial Assistance to Lower Drug Costs
- Conclusion
- Notes
- Appendix
- About The Author
Comparing Prices
Consumers have never had more opportunities to obtain information about drugs and possible substitutes, and to compare their prices. Shopping around town or on the Internet for price information can pay off.
Local Pharmacies. Surveys show that prices for generic equivalents vary widely. In a Missouri survey conducted for the Heartland Institute, prudent shopping saved consumers almost 10 percent on branded drugs and a whopping 81 percent on generics, on the average. Moreover, prices within a single city differed by 3 percent to 16 percent for brand-name medications and by 39 percent to 159 percent for generic medications. 4 In Houston, Texas, a physician who surveyed the prices of generic drugs she prescribed found that they varied by 50 percent to 80 percent. 5
“Patients should consider all options for drug purchases.”
Interestingly, small independent pharmacies often have better prices for generic medications than large chain stores. 6 Wholesale club chain stores consistently have the best prices. (Although they require memberships to purchase other goods, Costco and Sam’s Wholesale do not require membership to use their pharmacies.) Local drug prices may also vary depending on geographic location. Thus the lowest local price may not be the best price a consumer can get. Take the generic form of Prozac (Fluoxetine) used to treat depression. Many pharmacies mark up Fluoxetine by 3,000 to 5,000 percent over its wholesale cost. 7 As a result: 8
- Thirty doses of 20mg Fluoxetine cost as much as $55 at Walgreen’s in central Iowa. 9
- In Hampton Roads, Va., the same prescription sold for $45. 10
- In Florida, the cost at major drug chains ranged from $40 at Walgreen’s to just under $43 at Eckerd. 11
- In Detroit, Fluoxetine cost almost $47 at CVS stores, but sold for less than $9 at Beacon Hill Pharmacy. 12
Fluoxetine is also available from the Costco chain Web site for only $7.09. Thus, the lowest-price source for a drug may not be local, but on the Internet.
Internet Information Services. Generally, whether patients are comparing prices or learning about drug interactions, the Internet is their most valuable tool. Patients with prescriptions can find a wide range of prices by checking a few Internet pharmacy Web sites. A unique Web site called DestinationRx.com collects prices from numerous competing online pharmacies, allowing consumers to compare prices without going to individual pharmacy Web sites.
The new Medicare.gov Web site is an important tool for seniors with Medicare discount drug cards. In less time than it would take to compare bread prices in grocery store sales circulars, seniors can find the prices charged at dozens of local pharmacies. 13 [See below: “ Special Opportunities for Seniors: Medicare Discount Drug Cards.”] Prices can vary considerably. As the case studies in the appendices illustrate, consumers can save as much as 90 percent or more in some cases. [See Appendices B, C and D.]
